Document Detail


Benefits of quantitative gated SPECT in evaluation of perioperative cardiac risk in noncardiac surgery.
MedLine Citation:
PMID:  18092132     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Gated single-photon emission computed tomography (G-SPECT) was used to evaluate cardiac risk associated with noncardiac surgery and determine the benefits and indications of this technique for this type of surgery. MATERIALS AND METHODS: Patients scheduled to undergo noncardiac surgery under the supervision of anesthesiologists and subjected to preoperative cardiac evaluation using G-SPECT during the 26-month period between June 2000 and August 2002 were followed for the presence/absence of cardiac events (i.e., cardiac death, myocardial infarction, unstable angina, congestive heart failure, or fatal arrhythmia) during surgery and the postoperative period until discharged. Relationships between the occurrence of cardiac events and preoperative G-SPECT findings were evaluated. RESULTS: A total of 39 patients underwent G-SPECT; 6 of the 39 exhibited abnormal ejection fraction (left ventricular ejection fraction, LVEF<or=50%) and end-systolic volume (ESV>or=50 ml). Surgery was suspended for three of these six patients and cardiac events developed in the remaining three patients. Both abnormal perfusion images (PI) and abnormal wall thickening (WT) were observed in all six patients. All six patients exhibited abnormal LVEF and/or ESV. Three patients had either abnormal PI or WT, and a cardiac event occurred in one of them. Of the five patients who experienced cardiac events during or after surgery, two exhibited a short run of ventricular tachycardia requiring a continuous administering of antiarrhythmic drugs, whereas the remaining three patients exhibited cardiac failure requiring inotropic support following surgery. CONCLUSIONS: The results of this study indicate that the occurrence of perioperative cardiac events can be predicted by considering the severity of expected surgical stress and preoperative G-SPECT findings for LVEF, PI, and WT. We conclude that G-SPECT is quite useful for cardiac risk assessment in patients undergoing noncardiac surgery.
Authors:
Koji Watanabe; Yukio Ohsumi; Hirohiko Abe; Masahito Hattori; Shinya Minatoguchi; Hisayoshi Fujiwara
Publication Detail:
Type:  Journal Article     Date:  2007-12-25
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  21     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-02-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  563-8     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Hashima City Hospital, 3-246 Shinsei-cho, Hashima 501-6206, Japan. yoyo1@nifty.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiovascular Diseases / etiology*,  radionuclide imaging*
Female
Gated Blood-Pool Imaging / methods*
Humans
Male
Middle Aged
Perioperative Care / methods*
Postoperative Complications / etiology*,  radionuclide imaging*
Prognosis
Reproducibility of Results
Risk Assessment / methods*
Risk Factors
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon / methods*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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